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J Korean Acad Rehabil Med. 2004 Oct;28(5):412-417. Korean. Original Article.
Jang SH , Son SM , Ahn SH , Cho SH , Jang HW , Cho YW , Yang DS , Lee DG .
Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Korea. sumin430@hanmail.net
Department of Physical Therapy, Yonsei University College of Health Science, Korea.
Department of Diagnostic Radiology, Yeungnam University College of Medicine, Korea.
Abstract

OBJECTIVE: The aim of this study was to elucidate how the location of cerebral infarct influences cortical recovery pattern in hemiparetic stroke patients. METHOD: Forty-three chronic stroke patients and 21 control subjects were recruited for the study. The patients were classified into 4 groups according to infarct locations: cortex (CO), corona radiata (CR), posterior limb of the internal capsule (PL), and brainstem (BS). Functional MRI was performed using the blood oxygen level-dependent technique at 1.5 T with the motor task of hand grasp-release movements. RESULTS: The activation pattern of the primary sensori-motor cortex (SM1) was found to be significantly influenced by the lesion locations, but that of the secondary motor area was not (Pearson's chi-square test, p<0.05). The contralateral' SM1 activation was the major response in the control group (85.7%) and in the BS group (75.0%). On the other hand, the major activation pattern was `peri-lesional' in the CO group (peri-lesional 57.1%, peri-lesional and ipsilateral 42.9%), `bilateral activation' in the CR (85.7%) and the PL group (100.0%). CONCLUSION: Our results suggested that motor recovery mechanisms could be different according to location of cerebral infarct.

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